| Objective(1)In order to reduce the incidence of complications,improve the quality of life,and improve clinical outcome and prognosis,We observe the effects of Night extra meal on nutritional status,recovery of liver function,nutritional risk and incidence rate of complication,on the basis of the overall nutritional status and nutritional risk of the ACLF patients.(2)To find a cheap and effective extra meal model for the ACLF patients;(3)To provide a theoretical basis for the implementation of effective nursing intervention in clinical practice and to promote the rehabilitation of the ACLF patients;.MethodsIn this study,we randomly selected 101 ACLF patients who were enrolled in the Department of Infectious Diseases from a general hospital in Zhengzhou from December 2015 to June 2016.They were divided into two groups: the study group and the control group.The patients in first ward were treated with general internal medicine combined with daytime nutrition intervention as the control group,and the patients in another ward were the experimental group,who accepted night extra meal on the same basis.Night extra meal content: bread 40g+ yogurt 100 ml.Meal time for half an hour before going to bed or 9 to 10 p.m to give the extra meal,the observation period is within 24 hours after admission into hospital for a month.the baseline of both groups was recorded within 48 hours,a week and four week after admission,Including general condition questionnaire,NRS-2002 score,laboratory indicators: liver function(albumin,prealbumin);special protein(transferrin),anthropometric indicators: weight,body mass index(BMI),arm muscle circumference(MAMC),triceps skinfold thickness(TSF),Child-Pugh score at admission and discharge,two groups of patients’ complications,hospital stay,human serum albumin infusion during hospitalization,and patient disease outcome.All data were analyzed by SPSS20.0,and the test level was α = 0.05.The results are expressed as ± s.Statistical methods were performed using two independent samples t test,χ2test,repeated measurement of variance analysis.ResultThis study included 104 patients,52 patients in intervention group,52 patients in the control group,In the process of the intervention,3 cases were lost due to liver transplantation,infection,exacerbation,death and automatic withdrawal.the Sample attrition rates was 2.9%.To complete a total of 101 patients with the whole process of intervention,50 in the intervention group and 51 in the control group.The baseline data of the two groups before intervention were balanced,and there was no statistical significance between the two groups(P> 0.05).The scores of NRS-2002 in the intervention group were(1.60 ± 0.81)and(1.75 ± 0.74)in the control group before intervention.The statistical analysis showed no significant difference between the two groups(P>0.05).The scores of NRS-2002 in the intervention group were lower than those in the control group after one month of intervention,the difference was statistically significant(P <0.05);The Child-Pugh score of the intervention group was(9.54± 0.76)and the control group was(9.73 ± 1.02).The statistical analysis showed that there was no significant difference between the two groups(P>0.05).The Child-Pugh score of the intervention group was lower than that of the control group after one month of intervention,and the difference was statistically significant(P<0.05).The thickness of the skin fold were no significant difference(P>0.05)between the two groups before and after intervention in one week after the intervention the skin fold thickness in the intervention group was higher than that of control group,there was statistical the difference(P<0.05);The weight value is the same.The upper arm circumference and BMI value of the two groups had no significant difference between the two groups before and after the intervention,and there was not statistically significant difference(P>0.05).The biochemical indexes of two groups of patients were compared: There were no significant differences in the serum albumin values between the two groups before and after the intervention after a week(P>0.05).The serum albumin value of the intervention group was significantly higher than that of the control group after one month of intervention(P<0.05).The prealbumin and transferrin were the same.There was significant difference in the complication rate between the two groups during hospitalization(P<0.05).the difference of infectious complications was not statistically significant(P>0.05);non infectious complications related to the incidence of significant difference(P<0.05).There was no significant difference in human serum albumin infusion between the two groups(P>0.05),and two groups of patients hospitalization time had significant difference(P<0.05);The clinical outcome of the two groups was compared after the intervention.The clinical outcome was not statistically significant(P>0.05).Conclusion1.This study proves that nutritional risk is widely found in ACLF patients,and in the clinical it needs attention and give timely treatment.2.On the basis of routine treatment and nursing,night extra meal can effectively reduce the NRS-2002 score and Child-Pugh score of ACLF patients;3.The effect of night meal on improving the BMI,upper arm circumference and skinfold thickness index in the short term was not obvious,but the effect of improving serum albumin,prealbumin and transferrin was significant after one month of intervention.4.Night extra meal have an effect on the incidence of complications in both groups during hospitalization,especially in noninflammatory related complications;Night extra meal have no effect on human serum albumin infusion during hospitalization;There was a positive impact on the clinical outcome in the intervention group. |
PDF Full Text Request